sexual health: towards an integrated framework dr charlene rapsey department of psychological...
TRANSCRIPT
Sexual health: Towards an integrated framework
Dr Charlene Rapsey
Department of Psychological Medicine
University of Otago
Overview
1.Sexual health frameworks and background
2.From safe sex to good sex: Sexual health and lifestyles project
1. Prevalence of sexual difficulties2. Predictors of sexual difficulties
3.Implications for intervention
4.Questions
World Health Organisation Definition of Sexual Health
Sexual health is a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity.
Sexual health requires a positive and respectful approachto sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence.
For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.
(WHO, 2002)
(Adapted from Mason Durie's Whaiora: Māori Health Development. Auckland: Oxford University Press, 1994, page 70).
“Human sexuality researchers,
relationships researchers, and HIV
prevention researchers have not often fused
their research programs”
(Noar, Zimmerman, and Atwood, 2004).
…fragmented across many social sciencedisciplines with little integrative or collaborative efforts evident… sexuality is negatively viewed as the source of problems and disease rather than an integral part of human development and health…
(Di Mauro, 1997)
“…adolescent sexual dysfunction is an
oxymoron.” (Tolman, 2002b, p. 197)
RISK
alcohol
Condoms
STIsPregnancy
Chlamydia
Media sex
Climate change
Risk
Risk
HIV/AIDS
Teen parent
Safe sex
Condoms
RISK
Condoms
Pelvic inflammatory disease
Infection
Disease
contraception
STIs
contraception
disease
pregnantinfectionpregnant
pregnant
drugsHPV
partyBritney Spears
HIV
Reproductive management
Birth controlprotection
infection
SAFE
Adolescent Sexual Health
No hubba hubba
Genital herpes
From safe sex to good sex.
Method
Late Adolescent Sample
• N = 209• First-year tertiary students (University, Polytechnic,
Teachers’ College)• Living in halls of residence• Participants aged 17-21 (mean = 18 years)• Questionnaire: opt-in, 30-50% representation
Descriptives - Females
0
10
20
30
40
50
60
Low satisfaction Orgasmic difficulties Sexual pain
Sexual Difficulties
Per
cen
tag
e
Teens
Adult
Descriptives - Males
0
5
10
15
20
25
30
35
40
45
50
Low satisfaction Erectile difficulties Prematureejaculation
Sexual Difficulties
Pe
rce
nta
ge
Teens
Adults
Sexual satisfaction/difficulties and sexual risk behaviour
Late adolescent sample
Sexual Risk-Taking and Sexual Difficulties: Males
Sexual Risk Behaviours
r p
Sexual Satisfaction -.28** .006
Erectile Difficulties .24* .016
Early Ejaculation .25* .010
Sexual Risk-Taking and Sexual Difficulties: Females
Sexual Risk Behaviours
r p
Sexual Satisfaction -.25** .005
Sexual pain .08 .225
Orgasm difficulties .22* .011
Sexual satisfaction/difficulties and relationship satisfaction
Late adolescent sample
Relationship satisfaction and Sexual Difficulties: Males
Relationship Satisfaction
r p
Sexual Satisfaction .48** .000
Erectile Difficulties -.22* .048
Early Ejaculation -.23* .033
Relationship satisfaction and Sexual Difficulties: Females
Relationship Satisfaction
r p
Sexual Satisfaction .43** .000
Sexual pain .02 .418
Orgasm difficulties -.31** .001
Time together and Sexual Difficulties
Time togetherr p
Males
Sexual Satisfaction .53** .000
Erectile Difficulties -.27* .015
Early Ejaculation -.23* .040
Females
Sexual Satisfaction .48** .000
Sexual pain -.06 .277
Orgasm difficulties -.50** .000
“We have overlooked the very reason for coupling, namely to be intimate with another person” (Wright, 1998)
‘When you come to it, you feel like a dork
asking a guy to put a condom on’
(Abel and Fitzgerald, 2006)
Conclusions• Sexual health is comprised of physical,
mental, emotional, and social elements
• A wellbeing perspective benefits for multiple sexual health outcomes.
An integrated approach may allow for more effectively targeted interventions.
Acknowledgements
• Associate Professor Oliver Davidson• Department of Psychological Medicine• Libby Schaughency and Tamar Murachver• Andrew Gray• Amy Smith and Katie Ryan• University of Otago School of Medicine
“Finishing your PhD” scholarship• Participants and Halls of Residence staff
